Under Labour’s plans, NHS money would be used to buy thousands of care home beds in a bid to reduce overcrowding in England’s hospitals, long waiting times in emergency departments and patients stuck in ambulances.
Shadow health secretary Wes Streeting said the measures would tackle the huge human and financial “waste” caused by beds being taken up by patients who are fit to be discharged but are kept in hospital because of a lack of outside care. There are 13,000 such beds in England – enough to fill 26 hospitals.
If Labour wins the general election on 4 July, it will pump some of the NHS’s £165bn budget into the scheme as part of a series of immediate reforms to ease the crisis in the health service.
In his speech, Mr Streeting said a Labour government would want hospitals across England to follow the example of Leeds Teaching Hospitals NHS Trust, which is spending £9 million a year buying up care home beds to reduce discharge delays and free up beds.
The initiative, launched as a way to avoid a “winter crisis” in 2022/23, has freed up 165 beds, reduced the number of unavoidable hospital admissions and is estimated to have saved the trust between £17 million and £23 million.
“We will learn from the great innovation already happening in these health services and bring the best of them into other parts of the NHS,” Streeting said, holding up Leeds’ approach as an example while speaking to members of the Association of Health Journalists.
“I went to St Mary’s Hospital in Paddington. [in London] This month, a patient was hospitalized for 60 days because he was denied treatment, even though he had recovered enough to be discharged. This is not only a waste of the patient’s time and life, but also a waste of taxpayer money.
“Local community care shortfalls mean 26 hospitals are overwhelmed every day with patients unable to be discharged from hospital beds – and this failure costs £1.7bn a year.”
“Labour will get more hospitals to do what Leeds teaching hospitals are already doing – investing in local social care beds to get patients out of hospital sooner – better for patients and cheaper for the taxpayer.”
The 13,000 beds occupied by patients eligible for discharge represent one in seven of the total number of beds in the health service.
But one senior NHS official, speaking anonymously, questioned whether the NHS in England could afford to buy care home beds like Leeds has done. A £3 billion deficit by the end of 2024/25.
Emergency department doctors have welcomed the move, saying that if the plans are implemented as Mr Streeting hopes, it will ease the pressure on hospitals treating huge numbers of patients, allow ambulances to arrive faster after 999 calls and prevent patients from being left on trolleys or enduring “corridor care”.
“We support plans for NHS hospitals to buy up social care beds,” said Dr Adrian Boyle, president of the Royal College of Emergency Physicians.
“Currently, around 13,000 people are in acute hospitals and waiting for some form of social care. If we can reduce this horrific figure it can only be a good thing for patients and for hospital operations.”
“If this works well, it could be extremely useful in addressing all the issues in the emergency and critical care pathway from someone first calling 999, arriving at the hospital, being handed over to the emergency department and finally getting to the main hospital.”
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The Leeds Trust estimates that the proportion of hospital patients being able to be discharged within 27 days has increased from 21% to 38% as a direct result of spending millions on care home beds.
Sally Warren, policy director at the King’s Fund think tank, said: “The NHS and social care operate as part of one interconnected system – strain on one part of the system can lead to long waiting times in other parts.”
“Perhaps the most visible example is when a lack of community and social care support prevents people from being discharged from hospital, which results in no space to admit new patients and results in long ambulance queues in emergency departments every winter.
But, she added, “Let’s not confuse this approach. [in Leeds] “It’s a plan to solve all of social care’s problems. It’s primarily an effort to improve the flow of patients through hospitals, and it doesn’t address the fundamental mismatch between supply and demand for publicly funded social care in England.”
The idea of streeting is not new. The Department of Health and Social Care and NHS England In recent years, funds available for medical trusts Purchase nursing home beds and avoid the annual “winter crisis.”
Dr Tim Cooksley, immediate past president of the Society of Emergency Medicine, said: “It’s good to see Wes Streeting recognise this issue and is looking at solutions, but the focus should be on ensuring there are high quality community care beds with specialist rehabilitation teams, which will be a valuable addition to aged care.”
“Buying more care home beds will not, in itself, stop corridor care or improve outcomes for older people. Moving older people to the wrong place in the care system is like moving deck chairs on the Titanic – it doesn’t help older people and it doesn’t stop the overcrowding that so many people suffer in acute care corridors,” Cooksley added.
